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Aban Case Insurance Incontestability Clause Fraud Cases
Aban Case Insurance Incontestability Clause Fraud Cases
SECOND DIVISION
SYLLABUS
DECISION
In dismissing the case, the trial court found that Sotero, and
not respondent, was the one who procured the insurance; thus,
Sotero could legally take out insurance on her own life and
validly designate – as she did – respondent as the beneficiary.
It held further that under Section 48, petitioner had only two
years from the effectivity of the policy to question the same;
since the policy had been in force for more than two years,
petitioner is now barred from contesting the same or seeking a
rescission or annulment thereof.
Petitioner moved for reconsideration, but in another Order 19
dated October 20, 1998, the trial court stood its ground.
15
TSN, May 5, 1998, pp. 12-13; records, pp. 95-96.
16
Id. at 15; id. at 98.
17
Records, pp. 55-56; penned by Judge Ignacio M. Capulong.
18
Id. at 56.
19
Id. at 116-119.
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20
CA rollo, p. 46.
21
Id. at 48-56.
22
Id. at 59-60.
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I
[WHETHER] THE COURT OF APPEALS ERRED IN SUSTAINING
THE ORDER OF THE TRIAL COURT DISMISSING THE
COMPLAINT ON THE GROUND OF PRESCRIPTION IN
CONTRAVENTION (OF) PERTINENT LAWS AND APPLICABLE
JURISPRUDENCE.
II
[WHETHER] THE COURT OF APPEALS ERRED IN SUSTAINING
THE APPLICATION OF THE INCONTESTABILITY PROVISION
IN THE INSURANCE CODE BY THE TRIAL COURT.
III
[WHETHER] THE COURT OF APPEALS ERRED IN DENYING
PETITIONER’S MOTION FOR RECONSIDERATION.23
Petitioner’s Arguments
27
Great Pacific Life Assurance Corporation v. Court of Appeals, 375
Phil. 142, 152 (1999).
Supreme Court E-Library
period of two (2) years from the date of its issue or of its last
reinstatement, the insurer cannot prove that the policy is void ab
initio or is rescindible by reason of fraudulent concealment or
misrepresentation of the insured or his agent.
The purpose of the law is to give protection to the insured or his
beneficiary by limiting the rescinding of the contract of insurance
on the ground of fraudulent concealment or misrepresentation to a
period of only two (2) years from the issuance of the policy or its
last reinstatement.
The insurer is deemed to have the necessary facilities to discover
such fraudulent concealment or misrepresentation within a period
of two (2) years. It is not fair for the insurer to collect the premiums
as long as the insured is still alive, only to raise the issue of fraudulent
concealment or misrepresentation when the insured dies in order
to defeat the right of the beneficiary to recover under the policy.
At least two (2) years from the issuance of the policy or its last
reinstatement, the beneficiary is given the stability to recover under
the policy when the insured dies. The provision also makes clear
when the two-year period should commence in case the policy should
lapse and is reinstated, that is, from the date of the last reinstatement.
After two years, the defenses of concealment or misrepresentation,
no matter how patent or well-founded, will no longer lie.
Congress felt this was a sufficient answer to the various tactics
employed by insurance companies to avoid liability.
The so-called “incontestability clause” precludes the insurer from
raising the defenses of false representations or concealment of
material facts insofar as health and previous diseases are concerned
if the insurance has been in force for at least two years during the
insured’s lifetime. The phrase “during the lifetime” found in Section
48 simply means that the policy is no longer considered in force
after the insured has died. The key phrase in the second paragraph
of Section 48 is “for a period of two years.”
As borne by the records, the policy was issued on August 30,
1993, the insured died on April 10, 1996, and the claim was denied
on April 16, 1997. The insurance policy was thus in force for a
period of 3 years, 7 months, and 24 days. Considering that the insured
died after the two-year period, the plaintiff-appellant is, therefore,
barred from proving that the policy is void ab initio by reason of
Supreme Court E-Library
28
CA rollo, pp. 44-46.
Supreme Court E-Library
29
Tongko v. The Manufacturers Life Insurance Company (Phils.),
Inc., G.R. No. 167622, June 29, 2010, 622 SCRA 58, 75.
30
Republic v. Del Monte Motors, Inc., 535 Phil. 53, 60 (2006); White
Gold Marine Services, Inc. v. Pioneer Insurance & Surety Corporation,
502 Phil. 692, 700 (2005).
31
Eternal Gardens Memorial Park Corporation v. Philippine American
Life Insurance Company, G.R. No. 166245, April 9, 2008, 551 SCRA 1, 13.